Vancomycin non-sensitive Staphylococcus aureus

Reportable by Providers and Laboratories

About this Reportable Disease

Infectious agent:   Staphylococcus aureus is a bacterium commonly found on the skin and in the nose of about 30% of individuals.

Description of illness: Staphylococcal infections of the skin include pimples, boils, or other skin conditions and most are able to be treated by local drainage. When Staphlylococcal bacteria get into the bloodstream they can cause serious infections which can be fatal, including:

  • Bacteremia or sepsis when bacteria spread to the bloodstream; this may be a result of using catheters or having surgery.
  • Pneumonia (infection of the lung)
  • Endocarditis (infection of the heart valves) which can lead to heart failure.
  • Osteomyelitis (bone infection) which can be caused by staph bacteria traveling in the bloodstream or put there by direct contact such as following trauma (puncture wound of foot or intravenous (IV) drug abuse).

Interactive Disease Data


Laboratory Reporting for this Disease

Staphylococcus aureus, VISA/VRSA

TEST NAME Staphylococcus aureus (VISA/VRSA)
DISEASE/DISORDER Bacteremia, pneumonia, skin infections, surgical site infections
ALTERNATE NAME(S)

S.aureus, Vancomycin intermediate Staphylococcus aureus, Vancomycin

resistant Staphylococcus aureus, VISA, VRSA
METHODOLOGY Culture
SPECIAL INSTRUCTIONS

CEDEP approval required prior to isolate submission.
ORDERING INFORMATION TDH DLS Requisition:  PH-4182 Clinical Submission Requisition

Specimen Requirements

Patient Preparation
  • None
Specimen Collection
  • Isolate: Pure cultures
Specimen Labeling
  • Specimen must be labeled with at least two unique patient identifiers and match accompanying PH-4182 Clinical Submission Requisition.
Specimen Processing
  • None
Specimen Storage and Preservation
  • Isolates should be stored at ambient conditions.
Specimen Transport
  • Ship isolates in ambient conditions.
  • Do not send isolates refrigerated or frozen.
  • All infectious substance shipments must conform to U.S. Department of Transportation (DOT) Hazardous Materials Regulations (HMR 49 C.F.R. Parts 171-180). 
Specimen Acceptability and Rejection
  • Specimens that do not adhere to all specimen requirements will be rejected.
Testing Location
  • Nashville

Laboratory Reporting

Reporting requirements apply to all laboratories located within Tennessee, as well as laboratories outside of Tennessee that test residents of Tennessee, including laboratories located within healthcare facilities. Healthcare providers and laboratories in the same healthcare facility both have a duty to report. The type of organisms and analytes laboratories must report to TDH for 2026 are indicated, and there are several ways laboratories can report results to TDH.

Information about this Reportable Disease for Healthcare Providers

Clinical Summary

  • Definition: Staphylococcus aureus isolates with reduced susceptibility or resistance to vancomycin, including VISA (Vancomycin-Intermediate S. aureus) and VRSA (Vancomycin-Resistant S. aureus).
  • Epidemiology: Rare in the United States. Most cases are associated with healthcare exposure. Often occur in patients with prior MRSA infection and repeated or prolonged vancomycin use.
  • Transmission: Primarily spread through direct contact, especially via contaminated hands, surfaces, or medical equipment. Infection control practices similar to MRSA.
  • Clinical Manifestations:
    • Skin and soft tissue infections
    • Surgical site infections
    • Bloodstream infections (bacteremia)
    • Pneumonia
    • Bone and joint infections
    • May present similarly to MRSA infections.
  • Risk Factors:
    • Previous MRSA colonization or infection
    • Prolonged or repeated vancomycin exposure
    • Indwelling medical devices
    • Chronic wounds
    • Recent hospitalization or long-term care stay
    • Immunocompromising conditions
  • Laboratory Considerations: Confirmatory susceptibility testing required. Prompt notification of infection prevention and public health authorities is recommended.
  • Reporting: VRSA is nationally notifiable. Providers and laboratories should follow current state and local reporting requirements.

Healthcare Provider Reporting

Healthcare reporting requirements apply to all providers located within Tennessee, as well as providers whose patients reside in Tennessee.

Providers must report cases of all diseases and conditions listed through one of these methods:

• Mail or fax a completed PH-1600 form to your local health department or fax to the state health office at (615) 741-3857

• Send automatically via electronic case reporting (eCR). See this TDH webpage for more information on eCR, register at the Trader Partner Registration website, or contact MU.Health@tn.gov for assistance.

• Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting. 

• Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link. 

Information about this Reportable Disease for the Public

What Is It

Vancomycin non-susceptible Staphylococcus aureus refers to strains of “staph” bacteria that do not respond well to the antibiotic vancomycin. These strains include VISA (vancomycin-intermediate) and VRSA (vancomycin-resistant). They are rare but can cause serious infections.

How It Spreads

These bacteria spread mainly through direct contact, especially by unclean hands or contact with contaminated surfaces or medical equipment. Most cases occur in healthcare settings such as hospitals or long-term care facilities.

Who Is at Higher Risk

People at higher risk include those who:

  • Have had MRSA in the past
  • Have taken vancomycin for a long time
  • Have chronic wounds
  • Have medical devices like catheters
  • Have weakened immune systems
  • Have recent hospital or long-term care stays

Symptoms

Symptoms depend on the type of infection and may include:

  • Red, swollen, or painful skin infections
  • Fever or chills
  • Wound drainage
  • Cough or difficulty breathing (if pneumonia develops)
  • Feeling very ill (if bloodstream infection occurs)

Seek medical care if you develop signs of infection, especially after a recent healthcare stay.

Prevention

You can help prevent the spread by:

  • Washing hands often with soap and water or using alcohol-based hand sanitizer
  • Keeping wounds clean and covered
  • Taking antibiotics exactly as prescribed
  • Avoiding unnecessary antibiotic use

Healthcare facilities use special precautions, including gloves, gowns, and enhanced cleaning, to prevent the spread.

This Page Last Updated: March 25, 2026 at 8:53 PM